Primary pulmonary amyloidosis mimicking primary lung cancer.

Further Course • PET scan : minimal increased FDG uptake with a max SUV of 1.9 (Fig.2). There was no evidence of a high-uptake lesion anywhere else in the body. • Given the low SUV uptake (which can happen in inflamatory disorders) and that patient had recent pneumonia it was decided to follow it radiographically. • 3 months and 6 months chest CT scans: stable size and shape of nodule. • At 18 months: increase in size to 2.0 x 1.4 cm (Fig.3) with lobulated margins. • Trans-thoracic needle biopsy of nodule: amorphous, homogeneous material with a few lymphocytes on H& E staining (Fig.4). Congo red staining was positive (Fig.5), that confirmed amyloid deposition. Congo red polarized light: apple-green birefringence (Fig.6). • Diagnosis: primary nodular parenchymal pulmonary amyloidosis. • The patient is good clinical condition 1 year later.